RT Journal
A1 Shahian DM
T1 PReoperative β-blockade in coronary artery bypass grafting surgery
JF JAMA Internal Medicine
JO JAMA Internal Medicine
YR 2014
FD August 1
VO 174
IS 8
SP 1328
OP 1329
DO 10.1001/jamainternmed.2014.155
UL http://dx.doi.org/10.1001/jamainternmed.2014.155
AB
In the current issue, Brinkman and colleagues1 use the Society of Thoracic Surgeons National Database (STS-ND) to study the effect of preoperative β-blockade on postoperative coronary artery bypass grafting (CABG) outcomes. Their results show no mortality advantage and a paradoxically increased incidence of atrial fibrillation (AF) in patients receiving preoperative β-blockers, findings that challenge the continuation of this practice and its use as a quality metric. I will examine the rationale for preoperative β-blockade, controversies regarding its use in noncardiac surgery, the value of β-blockade in CABG, and reasonable clinical recommendations based on the preponderance of current evidence.